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Concurrent Alcohol and Steroid Abuse

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Anabolic steroids are synthetic drugs that mimic some of the hormonal effects that testosterone has on the body. They are sometimes used to prevent the loss of healthy body mass seen with chronic, ‘wasting’ conditions such as AIDS and some forms of cancer. Other medical uses include the treatment of abnormal growth rates and delayed onsets of puberty. Sometimes people obtain and abuse these steroids without prescriptions for the purpose of building muscle mass, reducing body fat, and improving athletic performance.

Anabolic steroids are usually injected or taken orally. Because users can easily develop tolerance to the drugs, they will typically practice “cycling.” This is a process whereby the user takes steroids for a designated amount of time, then takes a break for a few weeks or months before resuming use. Cycling is also practiced to avoid some of the adverse effects caused by anabolic steroid use. Anabolic steroids can have detrimental effects on the mind and body when abused in isolation, and their negative consequences are only amplified when they are combined with alcohol.

An article on the American Fitness Professionals and Associates website—written by exercise physiologist Mark Occhipinti, Ph.D.—points to one study that found that anabolic steroids are implicated in certain personality changes, such as an increase in alcohol consumption. This may seem counterintuitive for those who use steroids in order to improve muscularity and appearance, since alcoholism may often lead to losses of muscle strength and size.

Alcohol and Steroid Facts

  • Though there is no “high” typical of other substances, compulsive use or ‘steroid addiction’ is a very real phenomenon.
  • Many people who abuse anabolic steroids suffer from body or muscle dysmorphia.
  • Anabolic steroids can cause mood swings, aggression, and feelings of invincibility.
  • Chronic anabolic steroid use can wreak havoc on the human endocrine axis—causing the body to stop producing testosterone on its own.
  • Both anabolic steroids and alcohol are associated with liver, kidney, and heart problems.
  • Alcoholics have less muscle mass and strength than non-alcoholics.
  • Alcohol use disorder is linked to an increased risk of accidents, violence, and suicide.

Signs and Symptoms

Anabolic steroids differ from other substances that are taken for immediate highs because they are taken on a set schedule, over a period of time, in order to bring about a delayed reward of muscle strength and size, pleasing physical appearance, fat loss, and increased performance. The most obvious sign of a steroid abuser is a drastic or unnatural increase in muscle mass.

However, steroids also affect the user’s psychology. During the off period of a steroid cycle, it is common to experience a surge in estrogen, which has been suppressed by high testosterone levels. According to Dr. Occhipinti’s article, this can lead to depression. Furthermore, steroid use may be linked to long-term psychiatric problems.

Below are some signs and symptoms of concurrent alcohol and anabolic steroid use:

  • Acne.
  • Erratic mood swings.
  • Violent behavior.
  • Delusions.
  • Irritability.
  • Paranoid jealousy.
  • Slurred speech.

  • Unsteady gait.
  • Lack of coordination.
  • Stupor.
  • Attention or memory problems.
  • Uncontrollable eye movements.
  • Impaired judgment.

Gender-Specific Effects


  • Testicular shrinkage.
  • Infertility or decreased sperm count.
  • Baldness.
  • Breast growth.


  • Facial hair growth.
  • Deepened voice.
  • Irregular menstrual cycles.

Combined Effects of Steroid and Alcohol Abuse

Concurrent anabolic steroid and alcohol use can lead to a number of harmful effects on the mind and body, including the following:


  • Cancer.
  • Cirrhosis.
  • Fatty liver.
  • Alcoholic hepatitis.
  • Fibrosis.
  • Tumors.


  • Cardiac myopathy.
  • High blood pressure.
  • Irregular heart beat.
  • Heart attack.


  • Stroke.
  • Mouth and throat cancer.
  • Pancreatitis.
  • Tendon rupture.
  • Yellowing of skin and eyes (secondary to liver injury).
  • Fluid retention.
  • Increased risk of colon cancer in men.
  • Suicidal thoughts.

Treatment for Co-Occurring Alcohol and Steroid Addiction

Both alcohol and steroids cause a range of withdrawal symptoms, which exist on a continuum and range from uncomfortable to life-threatening. See below to learn symptoms of and treatments for withdrawal from each substance.

Steroid Withdrawal

Chronic anabolic steroid users will experience various withdrawal symptoms when they stop using the substance. Some common steroid withdrawal symptoms include:

  • Cravings.
  • Mood swings.
  • Restlessness.
  • Insomnia.
  • Decreased sex drive.
  • Depression.
  • Fatigue.
  • Loss of appetite.

Depression is the most dangerous withdrawal symptom, as it can lead to suicide attemptsan alarming risk among those in steroid withdrawal. Hospitalization is sometimes necessary due to this serious risk.

Anabolic steroid treatment sometimes involves treating the unpleasant withdrawal symptoms associated with cessation of use. Medications to manage withdrawal may include:

  • Pain relievers for joint pain, muscle pain and headaches.
  • Antidepressants to treat depression or to help manage body dysmorphic disorder, if present.
  • Medications to restore normal hormonal functioning.

Two therapies are cited as being beneficial in the treatment of steroid addiction:

  • Cognitive behavioral therapy: Used to rectify negative beliefs concerning body image and self-esteem, as well as explore the relationship between thoughts, feelings, and behaviors.
  • Motivational Interviewing: This form of therapy helps the client find internal motivation to change his or her behaviors.

Alcohol Withdrawal

Those suffering from alcoholism may experience some of the following alcohol withdrawal symptoms once use has stopped:

  • Anxiety.
  • Elevated heart rate.
  • Seizures.
  • Nausea or vomiting.
  • Hand tremors.
  • Sweating.
  • Insomnia.
  • Hallucinations.

These withdrawal symptoms can be uncomfortable and, in some cases, fatal. There are a number of medications that can help to treat alcohol dependence and promote abstinence:

  • Acamprosate: Helps to alleviate long-term symptoms such as anxiety and depression.
  • Disulfiram: When the user takes this and drinks alcohol, he or she experiences unpleasant effects such as heart palpitations and nausea. This mechanism promotes abstinence.
  • Naltrexone: FDA-approved medication that reduces cravings for alcohol.
  • Vivitrol: Extended-release version of naltrexone that is given intravenously once a month.

Treatment Programs

There are a number of recovery programs available that will treat concurrent alcohol and steroid addiction:

  • Inpatient treatment: You reside at the treatment center while receiving detox, a mental health evaluation, individual therapy, group counseling, and aftercare planning. This is recommended for severe co-occurring addictions.
  • Outpatient treatment: You live at home while receiving treatment around your schedule. This option is often sought by those with relatively mild addictions who are reluctant to leave behind various responsibilities, such as school or work.
  • Individual therapy: You meet one-on-one with a therapist, who will use a variety of therapies to promote healthy attitudes, positive behaviors, and abstinence.
  • Group counseling: For those who prefer group sessions, you will meet with a mental health professional and share your experiences related to steroid and alcohol addiction.
  • 12-Step programs: Alcoholics Anonymous and Narcotics Anonymous are fellowships that are free to join; the only requirement is that you wish to be abstinent. The environment is both encouraging and supportive.
  • Dual Diagnosis treatment: These centers will address co-occurring substance addiction and mental health disorders, e.g. depression or body dysmorphic disorder.


Teen Drinking and Steroid Abuse

Teens who abuse anabolic steroids are more likely to experience stunted growth and accelerated changes associated with puberty, in addition to all of the negative physical and psychiatric effects that adults experience. Adolescence is a turbulent time in which many individuals experience low self-esteem and negative body image. It comes as no surprise that teen boys may turn to anabolic steroids to gain muscle and confidence.


Research has revealed that teen boys who use steroids are more likely to have depression, low self-esteem, parents who worry about weight, inconsistent eating habits, and co-occurring substance abuse. These teens would benefit from education about the dangerous short- and long-term effects of steroid and alcohol abuse.

Over 3% of students in the United States have abused anabolic steroids (Kann, Kinchen, & Shanklin, 2014), and one study revealed that nearly 25% of adolescents who had taken steroids had shared needles in the past month. These teens are at risk of contracting infectious diseases such as HIV and hepatitis.

The National Survey on Drug Use and Health finds that drinkers under 15 are 4 times more likely to develop dependence and that though teens drink less often than adults, they tend to consume more in one sitting—increasing their risk of alcohol poisoning and overdose. It also found that 90% of the alcohol that teens consume is used in the form of binge drinking.

Learn more about teen alcohol and drug misuse.

Resources, Articles, and More Information

For additional information, see the following articles that address steroid use and the consequences of abuse:

If you or a loved one needs help with alcohol and steroid abuse, call us free at for help working through how you can receive assistance.

Join our community forum today to ask questions, find support, and share your story today.

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Lauren Brande, MA, has dedicated her life to psychological research. She started off her career with a scholarship from the Western Psychological Association for her undergraduate work in perceptual processing. In 2014, she achieved her master of arts in psychology from Boston University, harnessing a particular interest in the effects that drugs and trauma have on the functioning brain.

She believes that all research should be accessible and digestible, and her passion fuels her desire to share important scientific findings to improve rehabilitation.

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